Ebook Hybrid imaging in cardiovascular medicine: Part 1

Part 1 book “Hybrid imaging in cardiovascular medicine” has contents: Hybrid intravascular imaging in the study of atherosclerosis, combined ultrasound and photoacoustic imaging, X-ray fluoroscopy–echocardiography, hybrid x-ray luminescence and optical imaging,… and other contents.

Hybrid Imaging in Cardiovascular Medicine http://taylorandfrancis.com Hybrid Imaging in Cardiovascular Medicine Edited by Yi-Hwa Liu, PhD Albert J Sinusas, MD, FACC, FAHA Yale University School of Medicine CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2018 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S Government works Printed on acid-free paper International Standard Book Number-13: 978-1-4665-9537-8 (Hardback) This book contains information obtained from authentic and highly regarded sources Reasonable efforts have been made to publish reliable data and information, but the author and publisher cannot assume responsibility for the validity of all materials or the consequences of their use The authors and publishers have attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint Except as permitted under U.S Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www​ copyright.com/) or contact the Copyright Clearance Center, Inc (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-7508400 CCC is a not-for-profit organization that provides licenses and registration for a variety of users For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com I dedicate this book to my wife, Michele, for her love and support and most importantly her patience and understanding of my work schedule I would also like to acknowledge the support and guidance of my colleagues at Yale University and the many research and clinical fellows that I have had the pleasure of working with and mentoring over the years Albert Sinusas http://taylorandfrancis.com Contents Series preface ix Preface xi Acknowledgments xiii Editors xv Contributors xvii Part 1 PRINCIPLES, INSTRUMENTATION, TECHNIQUES, APPLICATIONS, AND CASE ILLUSTRATIONS OF HYBRID IMAGING Principles and instrumentation of SPECT/CT R Glenn Wells Cardiovascular PET-CT Etienne Croteau, Ran Klein, Jennifer M Renaud, Manuja Premaratne, and Robert A. DeKemp 27 Development of a second-generation whole-body small-animal SPECT/MR imaging system Benjamin M.W Tsui, Jingyan Xu, Andrew Rittenbach, James W Hugg, and Kevin B Parnham 57 Integrated PET and MRI of the heart Ciprian Catana and David E Sosnovik 75 5 CT-MRI James Bennett and Ge Wang 95 Hybrid x-ray luminescence and optical imaging Raiyan T Zaman, Michael V McConnell, and Lei Xing 117 X-ray fluoroscopy–echocardiography R James Housden and Kawal S Rhode 137 Combined ultrasound and photoacoustic imaging Doug Yeager, Andrei Karpiouk, Nicholas Dana, and Stanislav Emelianov 153 Hybrid intravascular imaging in the study of atherosclerosis Christos V Bourantas, Javier Escaned, Carlos A.M Campos, Hector M Garcia-Garcia, and Patrick W Serruys 185 Part 2 MULTIMODALITY PROBES FOR HYBRID IMAGING 211 10 Preclinical evaluation of multimodality probes Yingli Fu and Dara L Kraitchman 213 11 Multimodality probes for cardiovascular imaging James T Thackeray and Frank M Bengel 237 vii viii Contents Part 3  QUANTITATIVE ANALYSES AND CASE ILLUSTRATIONS OF HYBRID IMAGING 267 12 Recent developments and applications of hybrid imaging techniques Piotr J Slomka, Daniel S Berman, and Guido Germano 269 13 Multimodality image fusion Marina Piccinelli, James R Galt, and Ernest V Garcia 299 14 Quantitative cardiac SPECT/CT Chi Liu, P Hendrik Pretorius, and Grant T Gullberg 319 15 Evaluations of cardiovascular diseases with hybrid PET-CT imaging Antti Saraste, Sami Kajander, and Juhani Knuuti 351 16 Quantitative analyses and case studies of hybrid PET-MRI imaging Leon J Menezes, Eleanor C Wicks, and Brian F Hutton 365 17 Merging optical with other imaging approaches Doug Yeager, Nicholas Dana, and Stanislav Emelianov 377 Part 4 FUTURE CHALLENGES OF HYBRID IMAGING TECHNIQUES 413 18 Hybrid instrumentation versus image fusion: Path to multibrid visualization Ernest V Garcia and Marina Piccinelli 415 19 Concerns with radiation safety Mathew Mercuri and Andrew J Einstein 425 20 Future directions for the development and application of hybrid cardiovascular imaging Albert J Sinusas 439 Index 445 Series preface Advances in the science and technology of medical imaging and radiation therapy are more profound and rapid than ever before since their inception over a century ago Further, the disciplines are increasingly cross-linked as imaging methods become more widely used to plan, guide, monitor, and assess treatments in radiation therapy Today, the technologies of medical imaging and radiation therapy are so complex and so computer driven that it is difficult for the persons (physicians and technologists) responsible for their clinical use to know exactly what is happening at the point of care when a patient is being examined or treated The persons best equipped to understand the technologies and their applications are medical physicists, and these individuals are assuming greater responsibilities in the clinical arena to ensure that what is intended for the patient is actually delivered in a safe and effective manner The growing responsibilities of medical physicists in the clinical arenas of medical imaging and radiation therapy are not without their challenges, however Most medical physicists are knowledgeable in either radiation therapy or medical imaging and expert in one or a small number of areas within their discipline They sustain their expertise in these areas by reading scientific articles and attending scientific talks at meetings In contrast, their responsibilities increasingly extend beyond their specific areas of expertise To meet these responsibilities, medical physicists periodically must refresh their knowledge of advances in medical imaging or radiation therapy, and they must be prepared to function at the intersection of these two fields How to accomplish these objectives is a challenge At the 2007 annual meeting of the American Association of Physicists in Medicine in Minneapolis, this challenge was the topic of conversation during a lunch hosted by Taylor & Francis Group and involving a group of senior medical physicists (Arthur L Boyer, Joseph O Deasy, C.-M Charlie Ma, Todd A Pawlicki, Ervin B Podgorsak, Elke Reitzel, Anthony B Wolbarst, and Ellen D Yorke) The conclusion of this discussion was that a book series should be launched under the Taylor & Francis banner, with each volume in the series addressing a rapidly advancing area of medical imaging or radiation therapy of importance to medical physicists The aim would be for each volume to provide medical physicists with the information needed to understand technologies driving a rapid advance and their applications to safe and effective delivery of patient care Each volume in the series is edited by one or more individuals with recognized expertise in the technological area encompassed by the book The editors are responsible for selecting the authors of individual chapters and ensuring that the chapters are comprehensive and intelligible to someone without such expertise The enthusiasm of volume editors and chapter authors has been gratifying and reinforces the conclusion of the Minneapolis luncheon that this series of books addresses a major need of medical physicists Imaging in Medical Diagnosis and Therapy would not have been possible without the encouragement and support of the series manager, Lu Han of Taylor & Francis Group The editors and authors, and most of all I, are indebted to his steady guidance of the entire project William Hendee Founding Series Editor Rochester, Minnesota ix 196  Hybrid intravascular imaging in the study of atherosclerosis Moreover, the output of this combined NIRS-IVUS catheter has been merged with CTCA data This fusion has provided comprehensive 3-D models that allow assessment of the vessel wall geometry and of the distribution of the plaque and identification of the lipid-rich plaques on the vessel wall In addition, these 3-D objects can be used for blood flow simulation and evaluation of the association between shear stress and plaque composition (Figure 9.3) (Wentzel et al 2010) 9.4.4 Fusion of optical coherence tomography and coronary angiography The first methodology for the fusion of OCT and x-ray data was proposed in 2011 by Tu et al (2011) This approach was able to coregister the 3-D QCA and the OCT data in real time, facilitating application in the clinical setting A limitation of this method relates to the inability to estimate the correct orientation of the OCT borders onto the 3-D model In a more recent publication, this research group utilized the origin of side branches to determine the orientation of the OCT images, but again, they neglected the relative axial twist of the frames that occurs during the pullback of the catheter in tortuous vessels (Tu et al 2013) To overcome this drawback, Bourantas et al (2008, 2012) implemented the reconstruction methodology previously proposed for the fusion of IVUS and x-ray data This approach can be used only for the integration of the OCT data obtained at a low pull-back speed (i.e., using an M2 or M3 OCT system, LightLab Imaging, Westford, Massachusetts) and includes four steps: (1) the extraction of the OCT catheter path from two enddiastolic angiographic images, (2) the segmentation of the end-diastolic OCT frames, (3) the placement of the detected borders onto the 3-D path and the estimation of their relative axial twist with the use of the sequential triangulation algorithm, and (4) the determination of the absolute orientation of the first OCT frame using anatomical landmarks (i.e., side branches) that are visible in both OCT and x-ray angiography This reconstruction approach was implemented to identify the location of a ruptured plaque and demonstrate that the endothelial shear stress was increased at the ruptured site, confirming speculations and findings of previous reports (Fukumoto et al 2008) However, this methodology did not have broad applications in the research arena since it required a short interval between the end-diastolic OCT frames Therefore, this approach could not be implemented for the fusion of frequency domain (FD)-OCT with the x-ray data To overcome this limitation, Athanasiou et al implemented the simplified methodology proposed by Bourantas et al (2013) for the integration of IVUS and x-ray angiography data (Athanasiou et al 2012) To validate the performance of this approach, they compared the models and the shear stress values obtained by the integration of IVUS and x-ray images with those obtained by the fusion of FD-OCT and x-ray angiography These results demonstrated that the fusion of FD-OCT with the x-ray data provides geometrically correct reconstructions and allows detection of the segments that are exposed to a low athero-promoting shear stress environment with a high accuracy (Papafaklis et al 2013) This technique is anticipated to provide new insights into the mechanisms of coronary atherosclerosis, as it will allow us to examine the association between the local hemodynamic patterns and plaque characteristics that are unseen by IVUS (i.e., macrophages, neo-vessels, etc.) In addition, we will be able to detect with high accuracy the location of the ruptured plaques, assess the hemodynamic milieu in these segments, and appreciate the effect of the local hemodynamic forces on plaque destabilization and rupture (Cheng et al 2005; Ohura et al 2003; Stone et al 2003, 2012) Moreover, as we have recently demonstrated, the OCTbased reconstruction of stented or scaffolded segments appear capable to provide a detailed evaluation of the local hemodynamic environment and permit identification of the flow disturbances caused by the protruded struts, allowing a more accurate evaluation of the effect of shear stress patterns on stent thrombosis and restenosis (Figure 9.4) (Bourantas et al 2014) This reconstruction approach is likely to be useful in the future to examine in vivo the hemodynamic implications of different stent designs, thus allowing optimization of the configuration, thickness, and arrangement of the stent struts 9.4  Available software and methodologies for the co-registration of intravascular imaging data  197 (a) FD-OCT-based 3D reconstructed artery (b) BVS BVS (c) Shear stress Blood flow Shear stress 3.0 2.5 2.0 Follow-up Velocity 10.0 7.5 1.5 5.0 Strut 1.0 2.5 0.5 (Pa) (d) (cm/sec) (e) (f ) br 2.0 br (Pa) 1.5 1.0 0.5 (Pa) Baseline (h) (i) br * br * 1.5 * * BVS (j) 2.0 1.0 * * 0.5 (Pa) Baseline BVS (k) Follow-up 0.5 0.3 0.2 0.1 0.0 1.0 2.0 3.0 Baseline shear stress (Pa) IVUS-based 3D reconstructed artery (l) y = –0.062Ln(x) + 0.09 R2 = 0.50, p < 0.001 0.4 Follow-up Baseline FD-OCT-based 3D reconstructed artery 4.0 5.0 Neointima thickness (mm) Shear stress (Pa) IVUS-based 3D reconstructed artery Neointima thickness (mm) (g) Follow-up Baseline 0.5 y = –0.026Ln(x) + 0.02 R2 = 0.13, p < 0.001 0.4 0.3 0.2 0.1 0.0 1.0 2.0 3.0 4.0 5.0 Baseline shear stress (Pa) Figure 9.4  3-D reconstruction of the luminal surface of a coronary artery implanted with an Absorb bioresorbable vascular scaffold (shown at the top–left side of the figure) The model was obtained from the fusion of OCT and angiographic data (a) The shear stress distribution is portrayed in a color-coded map (the red color indicates high shear stress, and the blue, low shear stress) (b) Magnification of the proximal segment of the implanted scaffold The struts’ arrangement is apparent, which resembles the arrangement noted in a volume rendering 3-D OCT reconstruction and in an electron microscopy image acquired in a porcine model weeks post device implantation (c) Longitudinal section of the 3-D model The blood flow streamlines with the velocities shown in a color-coded display demonstrate recirculation zones proximally and distally to the protruded struts where the measured shear stress is low, while on the top of the struts, high shear stress is noted The high resolution of OCT allows more accurate evaluation of the lumen, identification of the protruded struts, and assessment of the neointima at 6-month follow-up (d, e, f) comparing to the IVUS, which cannot visualize details and thus the luminal borders are smother (h, i, j) and the 3-D reconstruction of the scaffolded segment has a different morphology (g) These differences appear to affect the shear stress distribution (e, i) The correlation between shear stress and neointima is higher in the OCT-based reconstruction at 6-month follow-up (r = 0.57) compared to the correlation reported in the IVUS-based model (r = 0.14) (k, l) (From Papafaklis MI et al., EuroIntervention, 9, 890, 2013 With permission.) 198  Hybrid intravascular imaging in the study of atherosclerosis 9.5 FUTURE DEVELOPMENTS IN INTRAVASCULAR HYBRID IMAGING 9.5.1 Fusion of intravascular ultrasound and optical coherence tomography imaging A hybrid IVUS-OCT imaging system is anticipated to overcome the limitations of each of the two modalities when applied independently and provide complete representation of coronary anatomy IVUS and OCT have complementary strengths as IVUS can “see” behind lipid tissue and has an increased penetration that allows visualization of the entire vessel wall, while OCT can “see” behind calcium and has high image resolution that allows visualization of details that are not portrayed in IVUS images Several studies provided proofs of this concept showing the superiority of the combined IVUS-OCT imaging over IVUS or OCT alone in the study of atherosclerosis (Diletti et al 2011; Goderie et al 2010; Gonzalo et al 2009; Sawada et al 2008) Hence, an effort has been made over the last years to develop dual-probe catheters that would be able to provide hybrid IVUS-OCT imaging The first catheters designed by Yin et al and Yang et al had the OCT and the IVUS transducer positioned side by side This arrangement resulted in an increased outer diameter of 2.4 mm and 2.8 mm, respectively (Yang et al 2010; Yin et al 2010) Li et al placed the OCT probe inside a centric hole of the IVUS transducer, but again, the size of this prototype was too big to allow intracoronary imaging (diameter of 2.5 mm) (Li et al 2010) To overcome this limitation Yin et al suggested a sequential arrangement of the OCT and the IVUS catheter This modification reduced the size of the catheter to 0.69 mm, allowing in vivo imaging, but it failed to resolve other limitations of the first designs such as the low image acquisition rate, the moderate image quality, and the low penetration depth of this OCT signal (Yin et al 2011) Recently, Li et al introduced a 4F, hybrid catheter that had a penetration depth of mm and provided coplanar IVUS and OCT imaging at a rate of frames/s Validation of the revision in 11 human coronaries obtained from seven autopsy cases demonstrated the potential of this hybrid imaging approach in the study of atherosclerosis Recently, the same research group introduced an updated revision that has a smaller diameter of 3F, allows more accurate coregistration of the IVUS and OCT, and permits hybrid image acquisition at a rate of 27 frames/s (Figure 9.5) A first-in-man study of a hybrid IVUS-OCT device is anticipated with interest as this hybrid imaging approach is expected to be useful not only in research but also in the clinical setting This hybrid catheter can potentially optimize outcomes following percutaneous coronary interventions IVUS would allow assessment of vessel wall dimensions, a necessity for the selection of the appropriate stent size, while OCT would provide a detailed evaluation of the final results, identification of the presence of stent underexpansion, struts malapposition, thrombus, or edge dissection and thus guide further treatment 9.5.2 Combined intravascular ultrasound and intravascular photoacoustic imaging Combined IVUS-IVPA imaging is anticipated to provide simultaneously information about the lumen and vessel wall morphology, the composition of the plaque, and the presence of inflammation Kapriouk et al were the first who combined a commercially available rotational IVUS catheter with a custom-designed fiber-based optical system that was able to deliver IVPA laser pulses (Karpiouk, Wang, and Emelianov 2010) Limitations of this prototype were the increased time required for hybrid imaging (approximately 25 s), the large diameter of the catheter, and the low image quality The same year, Hsieh et al developed a catheter that had an outer diameter of mm, which combined a phased array IVUS probe and a multimode fiber with a cone-shaped mirror for optical illumination (Hsieh et al 2010) Recently, Jensen et al introduced a miniaturized catheter comprising an angle-polished optical fiber adjacent to a 30-MHz ultrasound transducer with a diameter of only 1.25 mm suitable for intracoronary IVUS-IVPA imaging (Jansen et al 2010) The proposed device was tested in animal models; however, the suboptimal image quality and the increased time that is required for intravascular imaging, as well as concerns with regards the safety of IVPA, hamper its application in humans 9.5  Future developments in intravascular hybrid imaging  199 IVUS OCT mm IVUS transducer OCT (a) Protective housing OCT (b) IVUS OCT (c) (e) IVUS (d) (f ) Figure 9.5  First and second revisions of the hybrid IVUS-OCT catheter designed by Harduar, Li, and Courtney The first catheter, which has a 4F diameter, incorporates a protective housing (a) and there is a 90° offset between the IVUS and the OCT probe (c) In the new revision, the OCT catheter is integrated to the IVUS probe, the device has a smaller diameter (3F), (b) and the two transducers have a collinear alignment (d), which provides accurate coregistration of the OCT (e) and IVUS (f) images (From Nikas D et al., Curr Cardiovasc Imaging Rep, 411–420, 2013 With permission.) 9.5.3 Fusion of optical coherence tomography and near-infrared fluorescence spectroscopy Although OCT allows reliable identification of the presence of macrophages on the vessel wall, it cannot discriminate the activated from the nonactivated macrophages and give direct information about vessel wall inflammation Recently, Ryu et al introduced a dual modality catheter that allows simultaneous OCT and NIRF imaging (Ryu et al 2008) The probe features a double-clad fiber that has a single-mode core, which can transmit and receive OCT light, and a multimode light-guiding inner cladding that can transmit the NIRF excitation and receive and process the emitted fluorescence light The coregistration of the OCT and NIRF 200  Hybrid intravascular imaging in the study of atherosclerosis was performed with the use of side-viewing ball-lens located at the distal end of the fiber The diameter of the catheter is not different from a typical OCT device Validation of the prototype ex vivo in coronary artery specimens from cadavers and in vivo in a living rabbit showed that the proposed design allows detailed and comprehensive imaging of vessel wall morphology and pathophysiology (Yoo et al 2011) However, the safety of NIRF imaging has not been proven yet and thus further research is needed toward this direction 9.5.4 Fusion of intravascular ultrasound and time resolved fluorescence spectroscopy Several combined IVUS-TRFS catheters have been presented in the literature Stephens et al developed a hybrid catheter that featured an IVUS mechanical rotating probe, a side viewing optical fiber, and a steering wire that was connected to the distal end of the hybrid catheter and can be pushed forward to steer the device toward the luminal surface of the region of interest The feasibility of the proposed design was examined in vitro; however, the large diameter of the device (5.4F) and the fact that the TRFS signal has a poor penetration and thus it requires the catheter to be pushed onto the vessel wall have not allowed its in vivo implementation (Stephens et al 2009) Bec et al introduced an updated IVUS-TRFS revision that was able to overcome the limitations of the prototype of Stephens but had a rather large-diameter (7F) (Bec et al 2014) A miniaturized version of this prototype was presented by Ma et al (2014) In this design (diameter of the catheter: 3.5F) the optic fiber and IVUS probe were placed in parallel in a large oval-shaped shaft (largest diameter of 5F) The feasibility of this prototype has been examined ex vivo in the coronary arteries of 16 patients It was shown that combined IVUSTRSFS imaging was able to differentiate plaque phenotypes with a high sensitivity and specificity (89%, 99%) than standalone TRFS (70%, 98%) or IVUS (45%, 94%) (Fatakdawala et al 2015) However, the first in vivo applications of this device showed inaccuracies in the coregistration of the IVUS and TRFS data that were attributed to cardiac motion (Bec et al 2015) Currently, Marcu’s group is working toward the design of a new catheter that enables reliable IVUS-TRFS coregistration This new catheter is currently tested in swine coronaries 9.6 FUTURE PERSPECTIVE IN HYBRID INTRAVASCULAR IMAGING Although hybrid intravascular imaging techniques carry a great future potential, these hybrid approaches have limited applications in the study of atherosclerosis This should can be attributed partly to the fact that the existing software that has been developed for the fusion of different imaging techniques is not user-friendly and is available only in a few research laboratories In addition, most of the hybrid catheters that have been designed have significant limitations that not permit their applications in the clinical arena However, things are likely to change in the future The miniaturization of the medical devices, the new developments in catheter design, and the advances in image and signal processing are expected to overcome the current limitations and allow the construction of hybrid catheters that would be easy to use The development of user-friendly platforms will likely permit fast and reliable fusion of different imaging techniques in the future Whether these advances will change our clinical practice and replace standalone intravascular imaging with hybrid techniques is something that is difficult to predict, as it depends not only on the innovations in hybrid imaging but also on the evolution of standalone­intravascular imaging modalities; for example, in OCT, the penetration of the signal has been increased in the second-generation systems, while polarized OCT imaging has allowed the accurate detection of the fibrous tissue In IVUS, ACIST Kodama (ACIST Kodama Medical Systems Inc, Eden Prairie, Minnesota) has recently introduced a high definition catheter with improved image quality It should also be acknowledged that there is a trend toward noninvasive imaging over the last years, which has considerably reduced the applications of intravascular techniques in the study of atherosclerosis However, we believe that hybrid imaging will still play an important role Recently, the Lipid-Rich Plaque and the PROSPECT II studies have commenced and aim to utilize dual NIRS-IVUS three-vessel imaging to identify plaque characteristics that are associated with future cardiovascular events In addition, a smallscale serial intravascular imaging study, which incorporates IVUS and OCT imaging (i.e., the Integrated 9.7 Conclusions 201 Biomarkers Imaging Study 4), is currently underway and is expected to provide additional information about the atherosclerotic evolution and the mechanisms that are involved in this process 9.7 CONCLUSIONS Hybrid intravascular imaging has emerged over the last years to address the limitations of intravascular imaging techniques, and has broadened our knowledge about plaque development There is no doubt that most of the available hybrid approaches have failed to progress and have limited applications in research arena Further effort is anticipated over the upcoming years in the development of new imaging approaches with optimization of catheter design and advancement of reconstruction and co-registration software that are anticipate to overcome existing limitations and to broaden the applications of the hybrid imaging in the study of atherosclerosis REFERENCES Amano T, T Matsubara, T Uetani, M Kato, B Kato, T Yoshida, K Harada, S Kumagai, A Kunimura, Y Shinbo, H Ishii, and T Murohara 2011 Lipid-rich plaques predict non-target-lesion ischemic events in patients undergoing percutaneous coronary intervention Circ J 75 (1):157–66 Athanasiou LS, CV Bourantas, PK Siogkas, AI Sakellarios, TP Exarchos, KK Naka, MI Papafaklis, LK Michalis, F Prati, and DI Fotiadis 2012 3D reconstruction of coronary arteries using frequency domain optical coherence tomography images and biplane angiography Conf Proc IEEE Eng Med Biol Soc 2012:2647–50 Bec J, D Ma, DR Yankelevich, D Gorpas, WT Ferrier, J Southard, and L Marcu 2015 In-vivo validation of fluorescence lifetime imaging (FLIm) of coronary 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http://taylorandfrancis.com ... detectors 1. 4 3-D image reconstruction 1. 4 .1 Sampling requirements 8 10 11 11 1. 4.2 Filtered backprojection 11 1. 4.3 Iterative reconstruction 12 1. 5 Factors that influence SPECT image quality 1. 5 .1 Attenuation... Serruys 18 5 Part 2 MULTIMODALITY PROBES FOR HYBRID IMAGING 211 10 Preclinical evaluation of multimodality probes Yingli Fu and Dara L Kraitchman 213 11 Multimodality probes for cardiovascular imaging. .. 1. 5 .1 Attenuation 14 14 1. 5.2 Scatter 15 1. 5.3 Distance-dependent collimator resolution 16 1. 5.4 Patient motion 16 1. 6 Computed tomography 17 1. 6 .1 Basics of CT 17 1. 6.2 CT-based correction of nuclear medicine